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Three Types of Supplemental Medical Plans

June 18, 2002
Related Topics: Benefit Design and Communication, Health and Wellness, Featured Article, Compensation

The following are descriptions of the key features of three supplemental medical plans currently available.

Example 1: A personal indemnity policy
    Coverage highlights: Physician visit coverage varies from $15 to $25 per visit, depending on level of coverage purchased. Hospital confinement benefits varyfrom $50 to $200 per day based on level of coverage and duration of hospital stay. Diagnostic exams: up to $150 per test for covered sicknesses. Surgical: $100-$2,000 (excludes cosmetic or elective procedures not related to sickness). Hospital-based rehab services: $60 per day. Ambulance benefit: $100 for ground ambulance and $1,000 for air.

Example 2: A coverage gap-filler policy
    Coverage highlights: Five different benefit levels and four coverage options (single, employee and spouse, one-parent families, two-parent families) available. Benefits paid as lump sum per covered hospital confinement or outpatient surgery to help cover deductibles, co-payments, child care, or transportation to or from hospital. The policy is available with guaranteed-issue underwriting, assuming that minimum participation levels are achieved. As an individual policy, it’s portable and guaranteed renewable.

Example 3: A classic supplemental policy
    Coverage highlights: $200 a day for hospital confinement (limited to 90 days),an amount that is doubled for intensive care. It also covers $50 a day for attending-physician fees, 80 percent of usual and customary hospital expenses up to $5,000,up to $3,000 for inpatient or outpatient surgery, $75 for physician visits (after a $25 co-pay), and additional coverage for ambulatory care, emergency accident and ambulance services, prescription discounts, and a $10,000 critical illness benefit.

Workforce, July 2002, pp. 35-38 -- Subscribe Now!

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